Two doctors violated their responsibility to protect Anna Nicole Smith by prescribing massive amounts of drugs with the connivance of her lawyer-boyfriend, even though they knew she was addicted to painkillers, a prosecutor argued Wednesday.
But a defense attorney for Howard K. Stern said he loved Smith and depended on doctors to prescribe the right medications for her chronic pain. He said she was not an addict.
Smith's mother, Virgie Arthur, was in the courtroom with other relatives — a reminder of protracted court battles in the Bahamas and Florida after Smith died of a drug overdose in February 2007.
The contentions of Deputy District Attorney Renee Rose came during opening statements at the conspiracy trial of Stern, Dr. Sandeep Kapoor and Dr. Khristine Eroshevich, who are accused of providing vast amounts of powerful opiates and sedatives for the Playboy model under multiple names.
"None of it could have happened without Mr. Stern," Rose added during her two-hour presentation in Superior Court.
Stern's attorney, Steve Sadow, was the first to present the defense position. He said Stern was many things to Smith — lawyer, adviser, friend, manager and boyfriend.
"He cared for her and cherished her. He loved her," said Sadow. "Witness after witness will tell you that."
He said jurors would not be able to find a bad motive for Stern's actions. But he separated him from the other defendants.
"Howard K. Stern relied in good faith on the medical judgment of her doctors. He relied on their judgment on what was medically right and necessary for Anna Nicole Smith. Anna Nicole had pain, real pain, chronic pain."
Sadow stressed that Stern is not a doctor and suggested there was no conspiracy because, "If you don't know there's something wrong with what you're doing, there can't be an illegal agreement."
Stern and the doctors have pleaded not guilty to conspiracy to illegally furnishing the drugs. Each could face more than five years in prison if convicted, and the doctors would lose their medical licenses.
They are not accused of causing Smith's 2007 overdose death at age 39 at a Florida hotel.
Lawyers for the doctors and Stern have suggested they were desperately trying to save the doomed model during a period when she gave birth to a daughter and lost her grown son to a drug overdose.
Rose displayed pictures Wednesday on a courtroom screen of prescriptions that included methadone and Dilaudid, a drug known as "hospital heroin."
"Anna Nicole Smith took a lot of methadone for pain and she took Dilaudid on top of that," Rose said.
Kapoor's lawyer, Ellyn Garafalo, said Wednesday that Kapoor's prescriptions were appropriate and worked, and "he managed her pain and he acted in good faith."
"We're talking about long-term unrelenting pain," she said, "We don't look at how many pills are in the bottle. We're looking at whether a patient can live a normal life without pain."
She added, "We are not here to second guess medical judgment. In fact, a doctor's judgment is not subject to criminal prosecution."
Jurors also were shown pictures of Eroshevich with Smith following the 2006 birth of the model's daughter, Dannielynn.
The psychiatrist's attorney, Bradley Brunon, said the two women were friends and neighbors and when Smith's son died, she called her friend for help. He said Eroshevich rushed to bring drugs to her in the Bahamas. He said a controversial order for drugs, which a pharmacist refused to fill because he called it "pharmaceutical suicide," were never meant to be given all at once. He said they were part of a plan to try each drug and see which one would work best.
"It was a way to try to get medicines to a part of the world where they didn't have them," he said.
Rose argued Kapoor filled Smith's prescriptions, even though another doctor warned that she was an addict.
The prosecutor said Smith went to Cedars-Sinai Medical Center in 2006, where doctors advised weaning her from drugs because of her pregnancy. But Kapoor immediately began prescribing drugs for Smith again upon her release, Rose said.
The prosecutor quoted from a diary kept by Kapoor that spoke of the "mesmerizing" effect of being with a celebrity and added: "Can she ruin me?"
Rose also suggested that Smith was a coconspirator because she demanded drugs from doctors. Sadow accused the prosecutor of trying to say Smith "was a criminal" when all she wanted was to ease her pain. He described her as a strong willed and independent woman who took control of most things in her life including her medications.